Hormonal Acne Routine Part 4: The Cleanup Crew

This post is a continuation of my Hormonal Acne Series:

I have discovered the following about my own skin from years of trial and error and plenty of research. If you do not have the basics of skincare covered yet, then you have no business moving on to targeted acne solutions, especially not exfoliating actives. Please use great caution when introducing a new acne-fighting product. My routine is the result of many years of slow introduction and cautious experimentation. It should not be used as a shopping list for a newbie. Please read Part 1 for a summary of my acne troubles and my philosophies!

The Cleanup Crew

Between my AHA and my azelaic acid, I have a lot of intense, medically-researched power behind my acne-fighting routine. However, for dealing with healing and nearly-resolved acne that refuses to leave my face, I rely on over the counter, less intensive ingredients. Once clogs surface, my skin actually heals quickly if I give it proper nourishment. It's getting the clogs to the surface that's the biggest challenge. The cleanup routine I've developed has made the lifetime of each acne spot so much shorter- the time from when it first emerges to when it's banished for good has decreased dramatically from a few years ago when I first started to experience my adult acne.

Firstly, sheet masks have been a godsend. Any sheet mask will function the same for this purpose- it soaks and saturates your skin's surface in watery serum for a prolonged period of time (I mask for 20 minutes usually.) For acne that is scabbing over, a moist environment is key to allowing the skin to soften and heal. Just like you want to keep healing wounds moist with a bandage and ointment, a sheet mask works well to soak my "open" acne and seems to speed up the actual healing, with less irritability and hard scabbing. No matter the ingredients, just keeping a wet hydrating sheet on my face for 20 minutes does great things for those scabby bits...I have noticed that when I get those areas "waterlogged" they disappear much faster. However, most sheets masks in my stash also contain lots of anti-inflammatory ingredients that work to reduce redness and swelling of recovering acne. Because sheet masks are inherently hydrating/moisturizing, they make a natural complement to a more drying actives schedule. They are doing acne-fighting work but not adding to potential dryness. I reviewed some of them here.

The other moisturizing mask solution is the DIY honey mask, which works on two levels. One, honey is antibacterial and anti-inflammatory, which are key mechanisms to heal active acne. Two, the honey mask, when worn for prolonged periods of time (I try to wear them for 40 min to an hour) will create a similar moist environment as a sheet mask, but without the irritation prolonged sheetmasking yields for me. Besides the base mixture of toner and honey, I will add a bit of oil, serum, or even a bit of tea for extra soothing fun.

Clay mask and honey-matcha tea mask

My last mask is one I use sparingly- the clay mask. I consider this to be almost on the level of a chemical active, not because of how it works, but because of how drying and potentially irritating it is. I never use a clay mask on the same day as an active. I always moisturize heavily after a clay mask. And I never use a clay mask more than once a week. I will often push out my clay mask to once every 10 days to really make sure I don't overload my skin. Clay works by drawing out surface oils, and that's a slightly temporary cosmetic effect, but bentonite clay, the ingredient in most masks I use, also has shown antibacterial activity in certain scientific studies. I do feel that it has the ability to draw deeper bumps to the surface of the skin, dry out whiteheads and small surface pimples, and soothe irritated skin if used sparingly. I will usually follow my clay mask with a honey mask and even a sheet mask after the first two...because I feel the action of the clay is complemented by the two moisturizing measures.

In terms of spot treatments ("spot treatments) aka targeted non-exfoliating but nonetheless acne-focused treatments, I do not currently use the most popular one, benzoyl peroxide. I have in the past, and I find it extremely effective. However it can be slightly drying, so always use 2.5% which maximizes efficacy while minimizing side effects. A common alternative to BP is tea tree oil, which my skin loves. Tea tree and BP both have anti-bacterial activity which works on certain strains of acne-causing bacteria. If you've noticed either does not work for you, it means your skin may have predominantly a different strain of acne bacteria affecting it. Tea tree oil should not be used above low concentrations (typically 2-5%), so dilute it in carrier oil (NOT in water, that will grow mold) to use it safely without giving yourself nasty burns. Tea tree oil is a maintenance product for me- I use it regularly even when I have no big acne issues as it keeps my skin feeling and looking calm. It is best for emerging acne and acneic skin in general- I avoid using it on broken acne as it can burn and feel irritating.

Pure tea tree oil should be mixed to a level of 2% before use

The slightly unconventional/less-popular ingredient (at least in the USA) I love to use is zinc. I think zinc is a bit more common in French formulations than American ones, but it works on American skin, too, hey! My personal experience with zinc is that it is slightly drying when used alone, therefore even if you use a zinc cream with a moisturizing base, you will need to sandwich it with a moisturizing cream and a sleeping pack. Zinc is anti-inflammatory and highly soothing, so it is especially good for acne that has been picked and popped. I personally use a thicker, opaque zinc cream as a spot treatment (spread over smaller areas of my face) at night and a siliconey, transparent zinc product mixed into my moisturizer in the morning.

Both products from La Roche-Posay's Cicaplast Line

Because the majority of the "cleanup crew" is non-irritating, I can use them all in the same routine with powerful actives without overloading my skin. What I've found over the last few years is that actives alone never get the job fully done. My healing, emerging, and active acne needs different types of impact- moisture, dryness, soothing, etc. By having a multifaceted team, instead of just one "MVP" my skincare game has depth and breadth. The various skin emergencies that used to make me hide and cry are now a minor annoyance which can be tackled by any number of treatments I have in my regular rotation.Continued in Part 5....

I never knew that about zinc...must try it! I find that niacinamide makes the red marks from my acne disappear so much faster than ever before. I use the Cerave PM lotion, and with my Biore sunscreen, it's made a big difference. I also give 'breaks' in between chemical exfoliants, so it's nice to see someone else do it too. My questions is if you use any physical exfoliants as well? My 'dead skin' seems to stick around a lot, and if I don't regularly (like 1-2 times a week) physically exfoliate (my no name clarisonic knock off) I get more acne from it.

I realized after I published the series I didn't namedrop niacinamide once. That's because I'm allergic but I do rec it to everyone usually- it's such a gold star ingredient as it's not irritating but it has a wealth of benefits.

I don't ever use physical exfoliants...in the past I have experimented with a hybrid routine of some gentle physical + chemical but ultimately my skin seems to prefer an all-chemical route. Since I've been settled in the current routine I outlined, I haven't used my konjac sponge once in probably 3-4 months. I used to use it when I had tretinoin in my routine, as my skin would get a lot of surface skin "sticking" as you describe. With azelaic + salicylic + a buttload of moisture, my skin seems to shed more er, elegantly? I don't have as many problems but if you experience that buildup, it makes sense to replace one day of chemical exfoliation with physical. The one thing is to be super cautious not to stack the two methods to excess. Because physical exfoliation can be easily overdone (just an extra 30 sec of scrubbing) it is harder to balance them. But "caution" is something skincare lovers need in EVERY situation, not just yours :)